Đặc điểm rối loạn chức năng đường dẫn khí nhỏ ở bệnh nhi hen tại Bệnh viện Nhi Đồng 1

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Tác giả: Thị Mộng Trinh Huỳnh, Anh Tuấn Trần

Ngôn ngữ: Vie

Ký hiệu phân loại: 618.92 Pediatrics

Thông tin xuất bản: Nhi khoa 2023

Mô tả vật lý: 27-33

Bộ sưu tập: Metadata

ID: 393707

Thêm vào giỏ Liên kết toàn văn

Nghiên cứu được thực hiện nhằm khảo sát đặc điểm rối loạn chức năng đường dẫn khí nhỏ và ảnh hưởng của nó đối với trẻ mắc bệnh hen thông qua xét nghiệm dao động xung ký.Phương pháp nghiên cứu:Nghiên cứu mô tả cắt ngang, được thực hiện tại phòng khám Hô hấp, Bệnh viện Nhi đồng 1 từ tháng 9 năm 2020 đến tháng 4 năm 2021. Tất cả bệnh nhi hen (từ 3 -16 tuổi) có khả năng đo dao động xung kí được đánh giá trong nghiên cứu này.Kết quả:Trong 118 trẻ tham gia nghiên cứu, 42,4% trẻ có tắc nghẽn đường dẫn khí nhỏ trên IOS. Trẻ béo phì có nguy cơ tắc nghẽn đường thở nhỏ cao hơn so với nhóm không béo phì (OR= 2,86
KTC 95%: 1,23-6,66). Trẻ có rối loạn chức năng đường dẫn khí nhỏ có nguy cơ xuất hiện triệu chứng ban ngày >
2 lần/ tuần và triệu chứng ban đêm cao hơn so với nhóm còn lại, tỷ số chênh lần lượt là OR= 2,33 (KTC 95%: 1,11-4,93)
OR= 2,28 (KTC 95%: 1,08-4,8). Giá trị X5 và AX trước đáp ứng giãn phế quản, ở điểm cắt lần lượt là -0,36 kPa/L/s và 2,8 kPa/L, là 2 chỉ số tốt nhất để đánh giá hen không kiểm soát (AUC=0,68) với giá trị tiên đoán dương cao gần 80%.Kết luận:Rối loạn chức năng đường dẫn khí ngoại biên có mối liên quan mật thiết với tình trạng hen không kiểm soát. IOS là một phương tiện thăm dò chức năng hô hấp đáng tin cậy để khảo sát chức năng của vùng phổi này, nhất là ở trẻ em., Tóm tắt tiếng anh, Background: The involvement of peripheral small airways has recently gained greater recognition in asthma, and many studies suggest thatsmall airway dysfunction (SAD) plays an important role in the pathophysiology of asthma andstrongly contributing to a worse asthma control. Overall, the impulse oscillometry (IOS), introduced in the recent years, seems to be able to sensitively assess small airways, while conventional spirometry does not. Therefore, IOS may be of great help in characterizing SAD and guiding therapy choice.Purposes:This study aimed to determine the characteristics of small airways dysfunction and its influence on asthmatic children by using impulse oscillometry.Methods: A descriptive cross-sectional study conducted at the Pulmonology clinic of Children's Hospital 1 from September 2020 to June 2021. All patients who were 3 to 16 years of age, had a physician's clinical diagnosis of asthma and were able to performe impulse oscillometry were enrolled in the study.Results: Among 118 participants, we defined that the prevalence of asthmatic children were 42,4%. Obese children had a higher risk of peripheral airway obstruction thannon- obese group (OR= 2,86
KTC 95%: 1,23-6,66). Nocturnal symptoms were more common among patients who had small airways dysfunction (OR= 2,28
KTC 95%: 1,08-4,8).The frequency of hospitalizations and asthma exacerbations in group with SAD was significantly higher than the group with normal respiratory function. Receiver operating characteristic (ROC) analysis showed cut points for baseline X5 (-0,36 kPa/L/s) and AX(2,8kPa/L) that effectively discriminated controlled versus uncontrolled asthma (area under the curve 0,68) with high positive predictive value nearly 80%.Conclusions: Small airways dysfunction is associated with uncontrolled asthma.Impulse oscillometry is a reliableobjective and noninvasive measurement of lung function to examine small airway impairment in children, providing useful information in addition to the result of traditional spirometry.

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